Physical Therapy Advantage, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

1240 Issued in AR

Legal business name

PHYSICAL THERAPY ADVANTAGE, LLC

Practice address

52 Duclair CT
Little Rock, AR 72223-9570

Phone

(501) 519-0144

NPI assigned

May 1, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kelley Glenn, DPT

Title

Physical Therapist

Phone

(501) 519-0144

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Check Home Safety.com Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1184982894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 DUCLAIR CT",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722239570",
            "telephone_number": "501-519-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 DUCLAIR CT",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722239570",
            "telephone_number": "501-519-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY ADVANTAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "501-519-0144",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "AR",
            "license": "1240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KELLEY GLENN",
            "identifier": "1225144793",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Check Home Safety.com",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sarah T. S. Phillips, LCSW
• Dawn Jay Philpott, MED
• Phoenix Labs LLC
• Nirmal Kumar Phulwani, M.B.B.S.
• Linh Phung
• Physical Therapy Institute
• Physician'S Day Surgery Center
• Physicians Laboratories of America
• Olivia C Piazza, CRNA
• Patricia Piazza, LCSW

• Exclusive Provider Organization in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Exclusive Provider Organization in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.